In New Zealand (NZ), the incidence rate of end-stage renal disease (ESRD) for Pasifika is significantly higher compared to European. Despite the substantially higher incidence of treated ESRD in Pasifika people, the proportion of these patients who receive a kidney transplant is low. In 2019, a total of 221 patients in NZ received a kidney transplant and 54% were Caucasian while only 13% were Pasifika. Efforts to reduce this disparity in kidney transplantation is important because it is well established that renal transplantation confers a robust survival advantage over dialysis treatment for patients with ESRD. My proposed research aims to investigate the barriers faced by Pasifika patients being wait-listed for kidney transplantation before the initiation of dialysis, or to receive a living donor kidney transplant pre-emptively, compared to other ethnic groups. This is an important issue as the findings will contribute to improving kidney transplantation for Pasifika patients with ESRD.